Contract Pharmacy Details

WALGREEN CO.
CHC28961-05 Shawnee Christian Healthcare Center, Inc.

Covered Entity Details

Entity Name

Shawnee Christian Healthcare Center, Inc.

Subdivision Name

The Wellness Center @ Dawson Orman

Type

HRSA-Funded Health Center

340B ID

CHC28961-05

Entity Address

900 S Floyd St
Louisville, KY 40203-2331

Grant Number

H80CS28961

Participating Start Date

4/1/2020

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09005
200 E BROADWAY
LOUISVILLE, KY 40202-2008

Pharmacy Comments

Contract Details

Approval Date

10/15/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/17/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Susan Maguire, CFO
(502) 778-0001

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/15/2020

340B Drug Pricing Program Database